Background

In 2015, the Australian Medical Association (AMA) proposed to the Commonwealth Government to integrate non-dispensing pharmacists into general practice with the aim of reducing hospitalisations due to medication misadventure and reducing utilisation of medication.

 

Australian context

Significant changes to Australia’s population are predicted over the next 40 years. Australians are forecast to live longer with life expectancy of 95.1 years for men and 96.6 years for women, compared with 91.5 and 93.6 years in 2015. As well as living longer the structure of the population is predicted to change, with the proportion of the population aged over 65 set to double and those aged over 85 predicted to be four times higher.

The ageing population, coupled with an increase in prevalence and burden of chronic disease has resulted in increased demand on the Pharmaceutical Benefits Scheme with subsequent increasing medication use. As medication prescribing and use increases there is a resultant increase in drug related problems.

There is a significant cost to the health system associated with drug related problems including over-prescribing, medication misuse and adverse drug events often resulting in preventable hospital admissions. In 2015, the Australian Medical Association (AMA) proposed to the Commonwealth Government to integrate non-dispensing pharmacists into general practice with the aim of reducing hospitalisations due to medication misadventure, and reducing utilisation of medication. The proposal highlighted an independent analysis undertaken for the AMA by Deloitte Access Economics that showed the integration of pharmacists within general practices could deliver net savings to the health system of $545m over a four years period.

Regional snapshot

COORDINARE’s internally conducted analysis of prescription data on various medication types and classes at a wider catchment and sub-regional levels shows that there were pockets of the catchment namely the statistical areas[1] of South Coast, Shoalhaven (including Jervis Bay Territory) and Goulburn-Mulwaree that reported the highest opioid prescription rates with population based rates being substantially higher than other parts of the catchment[2].

Qualitative evidence from COORDINARE’s Needs Assessment suggests that sub-optimal medication management and irregular medication review contributes to avoidable hospitalisations and re-admissions. Further to this, challenges with communication between tertiary and primary care regarding medications prescribed on hospital discharge can lead to adverse events

[1] Areas used are as described in Ghosh A 2019, Population Health Profile: South Eastern NSW. COORDINARE – South Eastern NSW PHN. Available here: coordinare.org.au/about-us/our-region/regional-profiling-and-needs-assessment

[2] Ghosh A 2020, Population Health Analysis and Reporting (Unpublished) conducted for COORDINARE – South Eastern NSW PHN.